What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention

Jacqueline R. Bullis; Hannah Boettcher; Shannon Sauer-Zavala; Todd J. Farchione; David H. Barlow

doi:10.1111/cpsp.12278

What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention

Jacqueline R. Bullis, Hannah Boettcher, Shannon Sauer-Zavala, Todd J. Farchione, David H. Barlow

Research output: Contribution to journal › Review article › peer-review

150 Scopus citations

Abstract

We present a transdiagnostic definition of the commonly used, but poorly defined, term emotional disorder. This definition transcends and possibly complements traditional descriptive diagnostic categories, and candidate dimensional models of psychopathology by focusing on putative mechanisms that contribute to the onset and maintenance of disorders characterized primarily by dysfunction in the interpretation and regulation of emotion. We review three intermediate transdiagnostic mechanisms that characterize emotional disorders, such as, but not limited to, anxiety and depressive disorders, and then illustrate how this proposed definition applies to additional diagnoses beyond anxiety and depression. Implications of this new conceptualization of disorders of emotion are then discussed in the context of assessment, treatment, and prevention.

Original language	English
Article number	e12278
Journal	Clinical Psychology: Science and Practice
Volume	26
Issue number	2
DOIs	https://doi.org/10.1111/cpsp.12278
State	Published - Jun 2019

Bibliographical note

Publisher Copyright:
© 2019 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association.

Funding

Mojtabai, R., Stuart, E. A., Hwang, I., Susukida, R., Eaton, W. W., Sampson, N., & Kessler, R. C. (2015). Long‐term effects of mental disorders on employment in the National Comorbidity Survey ten‐ year follow‐up. Social Psychiatry and Psychiatric Epidemiology, 50(11), 1657–1668. https://doi.org/10.1007/s00127-015-1097-z Morey, L. C., Skodol, A. E., & Oldham, J. M. (2014). Clinician judg-ments of clinical utility: A comparison of DSM‐IV‐TR personality disorders and the alternative model for DSM‐5 personality disor-ders. Journal of Abnormal Psychology, 123(2), 398–405. https://doi. org/10.1037/a0036481 Morin, C. M., Rodrigue, S., & Ivers, H. (2003). Role of stress, arousal, and coping skills in primary insomnia. Psychosomatic Medicine, 65(2), 259–267. https://doi.org/10.1097/01.PSY.0000030391. 09558.A3 Mullins‐Sweatt, S. N., Lengel, G. J., & DeShong, H. L. (2016). The im-portance of considering clinical utility in the construction of a diag-nostic manual. Annual Review of Clinical Psychology, 12, 133–155. https://doi.org/10.1146/annurev-clinpsy-021815-092954 Murphy, M. J., & Peterson, M. J. (2015). Sleep disturbances in depres-sion. Sleep Medicine Clinics, 10(1), 17–23. https://doi.org/10.1016/j. jsmc.2014.11.009 Naragon‐Gainey, K., Gallagher, M. W., & Brown, T. A. (2013). Stable “trait” variance of temperament as a predictor of the temporal course of depression and social phobia. Journal of Abnormal Psychology, 122(3), 611–623. https://doi.org/10.1037/a0032997 National Institute of Mental Health [NIMH] (2015). NIMH Strategic Plan for Research (NIH Publication No. 15‐6368). Retrieved from http://www.nimh.nih.gov/about/strategic-planning-reports/index. shtml Netzer, L., Igra, L., Anan, Y. B., & Tamir, M. (2015). When bad emo-tions seem better: Experience changes the automatic evaluation of anger. Social Psychological and Personality Science, 6(7), 797–804. https://doi.org/10.1177/1948550615584198 New, A. S., aan het Rot, M., Ripoll, L. H., Perez‐Rodriguez, M. M., Lazarus, S., Zipursky, E., … Siever, L. J. (2012). Empathy and alex-ithymia in borderline personality disorder: Clinical and laboratory measures. Journal of Personality Disorders, 26(5), 660–675. https:// doi.org/10.1521/pedi.2012.26.5.660 Newman, R. J., Heath, A., Reich, W., Bucholz, K. K., Madden, P. A. F., Sun, L., … Hudziak, J. J. (2001). Latent class anaylsis of ADHD and comorbid symptoms in a population sample of adolescent female twins. Journal of Child Psychology and Psychiatry, 42(7), 933–942. https://doi.org/10.1111/1469-7610.00789 Nica, E. I., & Links, P. S. (2009). Affective instability in borderline per-sonality disorder: Experience sampling findings. Current Psychiatry Reports, 11(1), 74–81. https://doi.org/10.1007/s11920-009-0012-2 Norton, P. J. (2012). Group cognitive‐behavioral therapy of anxiety: A transdiagnostic treatment manual. New York, NY: Guilford.

Funders	Funder number
NIMH Strategic Plan for Research
National Institutes of Health (NIH)	15‐6368

Keywords

classification
comorbidity
emotional disorders
transdiagnostic

ASJC Scopus subject areas

Clinical Psychology

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10.1111/cpsp.12278

Cite this

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abstract = "We present a transdiagnostic definition of the commonly used, but poorly defined, term emotional disorder. This definition transcends and possibly complements traditional descriptive diagnostic categories, and candidate dimensional models of psychopathology by focusing on putative mechanisms that contribute to the onset and maintenance of disorders characterized primarily by dysfunction in the interpretation and regulation of emotion. We review three intermediate transdiagnostic mechanisms that characterize emotional disorders, such as, but not limited to, anxiety and depressive disorders, and then illustrate how this proposed definition applies to additional diagnoses beyond anxiety and depression. Implications of this new conceptualization of disorders of emotion are then discussed in the context of assessment, treatment, and prevention.",

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What is an emotional disorder? A transdiagnostic mechanistic definition with implications for assessment, treatment, and prevention

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

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